CT differentiation between vertebral multiple myeloma and osteolytic metastasis / 实用放射学杂志

Objective To explore the imaging differences of vertebral multiple myeloma(VMM)and vertebral osteolytic metastasis on CT. Methods Review the imaging signs of 32 patients with VMM and 52 patients with vertebral osteolytic metastasis,then record and finally statistical analysis was carried out.Results Compare to 1 67 vertebras involved in 52 cases of vertebral metastasis,the patents with VMM had 220 vertebras involved.The incidence of the multiple small circular type of bone destruction in VMM was 42.66%(93/218),which was higher than that in vertebral metastasis 0.00% (0/165)(χ2 =92.963,P =0.000).The incidence of the irregular shape type of bone destruction in VMM was 23.39% (5 1/218),while it was higher in patients with vertebral metastasis 45.45%(75/165)(χ2 =20.704,P=0.000).It was also found that the incidence of the fragmentary type of bone destruction and the involvement of the unilateral pedicle in VMM were lower than that in patients with vertebral metastasis 8.7% (19/218 )& 27.27% (45/165)(χ2 =23.238,P =0.000), 6.82% (1 5/220)& 1 7.96% (30/1 67)(χ2 =1 1.477,P =0.001).The incidence of the crest protrusion type of bone destruction in patients with VMM was 16.06% (35/218),however it was 9.10% (15/165)(χ2 =4.013,P =0.045)in vertebral osteolytic metastasis. Conclusion The imaging features of VMM and vertebral osteolytic metastasis had certain characteristic.And they can be differentiated from each other,combining with clinical traits.

Imaging diagnosis of congenital absence of the internal carotid artery / 中华神经科杂志

Objective To discuss the clinical and radiological features of congenital absence of the internal carotid artery.Methods Four patients of the congenital absence of the internal carotid artery were reported and the clinical and radiological features were summarized by a review of the literature.Results Four patients were shown subarachnoid hemorrhage ( SAH) , transient ischemic attack ( TIA) , epilepsy and headache, respectively.All of the four patients presented the absence of unilateral or bilateral carotid arteries in cervical computed tomography angiography ( CTA) or magnetic resonance angiography ( MRA).Carotid canal was absent in all the patients in CT base of skull and multiple intracranial vascular dysplasia was shown in all the patients.Basilar or posterior communicating artery was presented as dolichoectasia in 3 patients.There were 2 patients who suffered aneurysm.Conclusions The onset of the congenital absence of the internal carotid artery can be presented in any age.Sudden severe headache as initial symptom caused by SAH is showed more common in children and adolescents.TIA is commonly seen in the elderly.CT shows carotid canals are absent in the base of skull.Unilateral or bilateral carotid arteries are shown absent in CTA or MRA.Multiple intracranial vascular dysplasia is shown in CTA or MRA.Carotid artery CTA has been considered as the optimal imaging method of showing the congenital absence of the internal carotid artery.

Significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases / 中华放射学杂志

Objective To explore the incidence and significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases.Methods Imaging studies including MR,CT and plain radiograph were retrospectively reviewed in 245 cases of benign osseous tumors and tumor like diseases proved by pathology(borderline tumor,cases associated with pathological fractures,cases with lesions of skull were excluded from the study).The incidence of bone marrow and soft tissue edema were defined on T2WI with fat suppression on MRI in all the cases.x2 test was performed for the incidence rate of edema in the benign tumors and tumor like diseases.The pre-operative diagnoses were reviewed,and the influence of edema to the differential diagnosis between the benign and malignant was analyzed.Results The total incidence of bone marrow and soft tissue edema associated with benign tumors and tumor like diseases was 37.1％ (91/245),which included Langerhans cell histiocytosis 85.2％ (23/27),osteoblastoma85.0％ (17/20),osteoid osteoma93.6％ (29/31),ehondroblastoma 87.0％ (20/23).There was no statistically significant difference of edema incidence among the above-mentioned four diseases.(x2=6.35,P＞ 0.05).Both cases of endosteal capillary hemangioma had edema around.No edema was found around the lesions of other kinds of diseases.41 of 91 cases (45.1％) with edema were misdiagnosed as malignant tumor by MRI pre-operatively.Conclusion The marrow and soft tissue edema is a common sign in the benign bone tumor and tumor-like diseases,and it is frequently seen in Langerhans cell histiocytosis,osteoblastoma,osteoid osteoma,chondroblastoma.

The value of energy spectral CT in the differential diagnosis between benign and malignant tumor of the musculoskeletal system / 实用放射学杂志

Objective To explore the value of spectral curve in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Methods 100 patients with mass of the musculoskeletal system which were found by MRI underwent Dis-covery HD750 Gemstone CT scan ,and the images acquired were processed.Areas with homogenous density which did not contain necrosis,cyst,hemorrhage and calcification were chosen as region of interest(ROI).The optimal Kev on single energy images was selected,then the Kev-CT curve was automatically generated.All 100 patients proved by histological examination were divided into four groups,38 cases were as group A with benign tumor,10 cases as group B with borderline tumor,49 cases as group C with ma-lignant tumor and 3 cases of lipoma(that were analyzed separately since its curve was arc shaped).Average slope rate of every group was calculated according to the formula:K=(HU40keV-HU80keV)/40.Kruskal Wallis test was applied for statistical analysis,P value of less than 0.05 was considered statistical significant.Results The spectral curve of group C was sharply falling type with a mean slope rate of 1.64±1.00,that of group A was gradually falling type with a mean slope rate of 0.75±0.30,and that of group B was 1.34±0.45.The difference of slope rate between group A and C and between A and B were of statistical significance(P<0.05).The spectral curve of 3 lipomas showed arc shaped rising type with a mean slope rate of-2.00.Conclusion Spectral curve is useful in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Arc shaped curve is a specific sign for tumors containing abundant fat.

The radiological manifestation of hypophosphatasia / 中华放射学杂志

ObjectiveTo explore the radiological features of hypophosphatasia.MethodsFive cases of hypophosphatasia were definitely diagnosed,which included 3 males and 2 females aged from 5 months to 23 years.The laboratory assays were analyzed,radiological appearances of bone were determined and differential diagnoses were made.ResultsThe alkaline phosphatase in blood serum of five patients decreased,which were 8,20,13,21,and 18 U/L respectively.Phosphoethanolamine increased in blood serum of the five patients,which were 16.5,13.5,21.6,18.7,and 28.9 μmol/L respectively.Phosphoethanolamine also increased in urine,which were 2350,9120,3520,5280,and 1820 μmol/L respectively.Calcium in blood serum increased,which were 4.2,5.6,4.9,6.1,and 3.5 mmol/L respectively.X-ray images displayed that the density of bone decreased in 5 cases,the metaphyses exhibited widening and cupping in 4 cases,the provisional calcification zone of the metaphysis became thinning or disappearing in 4 cases,long bone bended in 4 cases and pathologically fractured in 1 case.Conclusion Hypophosphatasia can be indicated by its relatively special radiological appearance,and it can be diagnosed and differentiated from rickets,osteomalacia and osteogenesis imperfect by the laboratory examination combined with its clinical presentation.

The experimental quantitative study of spectral CT imaging in reducing the metal artifacts / 中华放射学杂志

Objective To assess the value of spectral CT in reducing artifacts caused by metallic implants. Methods Porcine lumbar spines were chosen as anthropomorphic phantom. The model was examined before and after implanting the titanic nail into the second and fourth lumbar vertebral body using gemstone spectral CT protocol and standard 120 kVp spectra. Specific pest-processing technique was applied to generate 11 kinds of images of monochromatic energy and Metal Artifacts Reducing system (MARs) with the interval of 10 keV ranging from 40-140 keV. The image quality was compared subjectively between 120 kVp group and GSI group after implantation. Three regions of interest based on distances along the most pronounced artifact were chosen and marked as ROInear, ROImid, ROIfar successively. Artifacts parameters including CT value and SD value were measured. The CT value of different ROIs were compared with LSD and Bonferroni test. Contrast-to-noise ratio and artifacts index were calculated. An optimal range of keV was determined according to artifacts index. Results Image quality of Gemstone spectra images was rated superior to the standard images. An optimized spectrum of keV based on artifacts index was from 80 keV to 100 keV. For ROInear,CT value was ( 80. 25 ± 16. 00) HU and ( 30. 10 ± 10. 45 ) HU respectively in group Mono before implantation and group Mono + MARs after implantation. The differences were significant( Z =2. 978, P ＜ 0. 05 ). For ROImid and ROIfax, CT value was ( 63.21 ± 6. 61 ) HU and ( 54. 84 ± 10. 60 ) HU,(76. 54 ±9.07)HU and (73.20 ±5.39)HU respectively. There was no significant differences (t =0. 530,P ＞ 0. 05; t = 0. 822, P ＞ 0. 05 ). Conclusions Metal artifacts could be reduced effectively at the site 3 cm away from implants using gemstone spectral CT. An accurate CT value of surrounding tissue can be obtained.

The Diagnostic Value of Parasagittal Reconstruction CT for the Lumbar Intervertebral Foraminal Stenosis / 实用放射学杂志

Objective To discuss the diagnostic value of parasagittal reconstruction CT for the lumbar intervertebral foraminal stenosis.Methods From Jan.2003 to Apr.2004,15 suspected cases with lumbar intervertebral foraminal stenosis based on the routine clinical and radiologic examinations were diagnosed by means of the CT parasagittal reconstruction and operated on .Results All showed L_(4~5) or L_5~S_1 foraminal stenosis,2 cases far lateral disc protruded,8 cases the vertebral endplate posteriolateral spurs extruded into foramina,1 spondylolisthesis pseudoarthrosis pressed,4 cases had the narrow intervertebral space along with the flavum ligament hypertrophy and facet superioanterio subluxation. 7 cases showed horizontal stenosis and 8 cases showed vertical stenosis.6 cases wereⅡ?,9 cases were Ⅲ?. Conclusion The parasagittal reconstruction CT for the lumbar foraminal stenosis can compensate for the drawbacks of the routine axial CT, show more clearly and vividly and guide the operations more accurately.

Clinical Application of 3D-CT Reconstruction Using Spiral CT in the Diagnosis of Surface-involved Lesions of Bone-Compared with Plain Film and 2D-CT / 实用放射学杂志

Objective To study the value of 3D-CT reconstruction in the diagnosis of surface involved lesions of bone for its nature and location,comparing with plain film and 2D-CT.Methods Surface-involved lesions of bone revealed by plain-film were performed spiral CT examination.Multi-planar reconstruction(MPR)and surface shading display(SSD)were performed among 20 cases which had pathologic results.The diagnosing correct rate of nature and location in all the techniques were compared.Results The correct rate of nature diagnosing of plain film,2D-CT,MPR and SSD was 75%,80%,65%,60% respectively;correct rate of location diagnosing was 90%,75%,85%,95% respectively.The highest nature diagnostic correct rate was found in 2D-CT.The highest location diagnostic correct rate was found in SSD.Conclusion Spiral CT stereoscopic reconstruction is of great value in the location diagnosing of surface-involved bone lesion.

To Obtain Radiology Literature From the Internet / 实用放射学杂志

Objective To collect the URL of Chinese and English periodicals and medical seraching engines,sum up the methods and procedures of getting radiolgical literature from the Internet.Methods To search URL with a computer connected to the Internet,by software of Internet Explorer and searching engines known.Results The URL of 21 English and 11 Chinese radiological perodicals,14 searching engines,4 medical databases were obtained,which can be used to find the abstract and full text of the articles we want from the internet.Conclusion To obtain radiological literature from the internet can be easy,convenient,rapid and economical.

Silicosis:The Evaluation of Pulmonary Function Damage with Multi-slice Spiral CT / 实用放射学杂志

Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.

The Value of Different Angle MPR Using Multi-slice Spiral CT in Diagnosing Lumbar Spondylolysis / 实用放射学杂志

Objective To study the value of different angle MPR using 64-slice CT in diagnosing spondylolysis.Methods The volume data of isotropic scanning in 50 cases of spondylolysis using 64-slice CT were post-processed by different angle MPR. Four scanning modes were imitated: conventional intervertebral disc scanning mode, transverse scanning, oblique transverse scanning along the direction of vertebral arch, longitudinal and sagittal images of lumbar vertebrae. The detective rate of isthmus fissue, dislocation of disruption end, bone frature piece, false joint of above four methods were analysed. Results The sensitivity of detecting the isthmus fissue was highest by sagittal MPR and oblique transverse MPR images (100%)(u=8.51,P

The clinical application of 64-slices spiral CT in angiography of coronary artery / 中华放射学杂志

Objective To study the clin ic al application of 64-slices spiral CT in coronary artery. Methods Twenty-six patients were performed 64-slices spiral CT in coronary artery, 15 of the 26 patients underwent selective coronary artery angiography. Results The main branches and part of the sub-branches o f the coronary artery were clearly displayed. 38 coronary artery branches of 16 patients were found stenosis. In 15 cases with conventional angiography, all mai n branches and parts of sub-branches of coronary artery were displayed clearly. All patients demonstrated coronary artery stenosis. The diagnostic accuracy of 64-slices spiral CT was 94.12%. Conclusion As a minimall y invasive examination, 64-slices spiral CT is a valuable method to detect and diagnose the diseases of coronary artery.

The Clinical Significance of Bone Destruction of Maxillary Sinus / 实用放射学杂志

0.05).84.58%(28/33)of the expanding bone destruction were resulted from benign and 84.62%(33/39) of the aggressive bone destruction were resulted from malignant.The form of bone destruction of maxillary sinus in the benign and the malignant was different(? 2=34.61,?

The Application of Post-processing After Multi-slice Helical CT Scanning in the Study of Cervical Vertebrae / 实用放射学杂志

Objective To study the method and ability of multi-slice CT isotropic scan and post-processing in displaying the anatomy of cervical vertebrae.Methods The normal cervical spines in 53 cases were scanned with isotropic parameters using 16-slice-helical CT.All the images were post-processed with the methods of MPR,MIP,SSD and VRT and each other were compared between them,then the best one was selected to compare with axial CT images and plain films.The abilities in displaying inter-vertebrae disc,spinal canal longtitude,vertebrae body,vertebral arch,zygapophyseal joint and inter-vertebrae foramen were compared among the 3D reconstruction,direct CT scan and X-ray plain film including post-anterior,lateral,left-anterior oblique and right-anterior position project.Results The quality of isotropic post-processing images had no remarkable differences with that of direct CT scan in showing inter-vertebrae disc,but it was better than X-ray plain film and conventional CT scan mode in showing other structures.Conclusion The multi-slice helical isotropic CT scan and post-processing images are of great value in the study of cervical spine.